Sisters of the Precious Blood Dayton, OH Anna Marie Tag, RSM, MBA, NHA NRRO Elder Care Consultant July 1, 2017

2015 Assembly Directive END OF LIFE TRANISITIONS AND CARE The Sisters of the Precious Blood value person-centered care in transitions of life and sustaining our sisters as long as possible in a homelike environment. We commit to doing an assessment of all areas of care services for our Sisters at Salem Heights and Emma Hall. This assessment is a priority and should engage a gerontology expert and the Sisters with implementation as appropriate.

Committee Members Beverly Bodnar, C.PP.S. Maryann Bremke, C.PP.S. Jeanette Buehle, C.PP.S. Jean Rene Hoying, C.PP.S. Judy Niday, C.PP.S. Nancy Raley, C.PP.S. Margo Young, C.PP.S. Linda Pleiman, C.PP.S – Liaison to Committee

Goals of the Committee To help the community to see what is already in place, To point out what is missing from the continuum of service, and To provide informed suggestions to improve the life and care services for members Since 1999

Not Included in the Scope of Work Evaluations of any religious or lay staff holding positions at Salem Heights or Maria Joseph Health Center

Community’s Strengths/Advantages Caring Community Commitment to respect the dignity of each member Foresight to renovate living space for members who are independent or independent with services Willingness to assess the continuum of care as it presently exists Sufficiently funded for retirement needs of all members

Community’s Challenges/ Opportunities for Improvement Declining membership (108) Increasing age of membership (Median age: 79) Differing opinions regarding the increase of clinical staff at Salem Heights Frustration/anger/sense of loss related to having “influence” rather than “control” at MJC Very limited health care experience (consumers) Sufficiently funded for retirement needs of all members

Sisters of the Precious Blood

Membership Projections Next Twenty Years Equal To Or Above 80 2017 108 members 2022 83 members 2027 60 members 2032 37 members 2037 20 members 2017 50 46% 2022 54 65% 2027 47 78% 2032 33 89% 2037 18 90%

Levels of Care Independent Independent with Services Assisted Living Skilled Nursing Custodial

Skilled Nursing Care Every Licensed Skilled Nursing Facility in the United States is under the jurisdiction of the Centers for Medicare and Medicaid Services(https://www.cms.gov) Facilities are reviewed annually (within a nine to fifteen month window from the previous year) Results are a matter of public record (CMS website) and are required to be posted in a public spot in the facility

Nursing Home Compare Each Skilled Nursing Facility is rated by the CMS Five Star Rating System Health Inspections: based on number, scope and severity of the three most recent surveys Staffing: Registered nurse hours per resident day and total staffing hours per resident day QMs: Quality Measures include 8 long-stay measures and 3 short-stay measures

Scope and Severity No actual harm with potential for minimal harm (A-C) No actual harm with potential for more than minimal harm that is not immediate jeopardy (D-F) Actual harm that is not immediate jeopardy (G-I) Immediate jeopardy to resident health or safety (J-L)

Nursing Home Compare (OHIO) Maria Joseph Living Care Center Diversicare of Siena Woods Cypress Pointe Health Campus Friendship Village St. Leonard Health Care Center

Strengths-Weakness-Opportunities-Threats (SWOT) Salem Heights Maria Joseph Center

Recommendations Community Wide Recommendation Health and Wellness Coordinator Hire a Health and Wellness Coordinator as there is a need for a stronger professional standard for overall decision making and planning for members’ health and wellness

Recommendations Continued Salem Heights That Salem Heights be maintained as it was originally intended: A facility for Independent Living and Independent Living with Services (Domestic: food, housekeeping and some minor assistance for health care) That each of the ten Criteria be reworked to indicate measurable objectives indicating what can be accommodated and what requires a higher level of care That an ad hoc committee be established to plan for a change in the Purpose of Salem Heights as the number of sister residents declines and the advent of lay residents

Recommendations Continued Maria Joseph Center (MJC) Re-evaluate the amount of rented space for sister staff. Suggest continuation of one office and chapel. Re-evaluate the number of rooms kept on “reserve”. Prepare a two to three-year comparison of admissions compared to unused reserved “days”

General Recommendations That the Retirement Plan of 1994 be updated to include the acceptance of any recommendation from the elder care services report That the “Plan” is a life plan of wellness, transition, options for care and expectations of members through each phase of live until death That the community plan for continued education on transition dealing with loss of independence, grief and acceptance of the aging process

Questions/Clarifications